Stimulated potential analysis using concentric needle electrodes (SPACE) in paediatric EMG

It is important to have a method to diagnose neuromuscular junction abnormalities in children. The neuromuscular junction in children can be affected by autoimmune myasthenia gravis or congenital abnormalities of the neuromuscular junction. Both conditions are rare in children and often do not present with recognizable clinical stereotypes. Many are treatable once diagnosed. Repetitive nerve stimulation is a well-recognized technique but is relatively insensitive. SFEMG offers high levels of sensitivity and is the preferred technique in children. Voluntary SFEMG is rarely possible to do consistently in children. Stimulated SFEMG can with practice be performed on any child from the neonate to the teenager. This presentation describes the use of a modification of Stim SFEMG which uses concentric needle electrodes (SPACE).